Provider Demographics
NPI:1437752680
Name:DEYRIS CORREA THERAPY LLC
Entity Type:Organization
Organization Name:DEYRIS CORREA THERAPY LLC
Other - Org Name:PLAY & LEARN THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEYRIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORREA FORTEZA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:786-291-2578
Mailing Address - Street 1:10951 SW 72ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2743
Mailing Address - Country:US
Mailing Address - Phone:786-291-2578
Mailing Address - Fax:
Practice Address - Street 1:10951 SW 72ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2743
Practice Address - Country:US
Practice Address - Phone:786-291-2578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center